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Characteristics of hyperfibrinolysis in dogs and cats demonstrated by rotational thromboelastometry (ROTEM)


Sigrist, Nadja; Jud Schefer, Rahel; Kutter, Annette P N (2018). Characteristics of hyperfibrinolysis in dogs and cats demonstrated by rotational thromboelastometry (ROTEM). Veterinary Journal, 242:67-73.

Abstract

Hyperfibrinolysis (HFL) is a pathophysiological mechanism that has not been described in dogs or cats extensively. The aim of this study was to describe rotational thromboelastometry (ROTEM) parameters and underlying diagnosis in dogs and cats with HFL and evaluate association with bleeding diathesis. The ROTEM database was retrospectively searched for EXTEM (ROTEM activated with proprietary tissue factor) tracings with maximum lysis at 60 min ≥15%. Concurrent ROTEM and plasma coagulation tests, thrombocyte number, diagnosis and survival to hospital discharge were extracted from medical records. Analysis of differences between dogs and cats and of factors associated with bleeding, fulminant HFL (clot breakdown within 30 min) and survival to hospital discharge were performed.

Hyperfibrinolysis was detected in eight cats presenting with haemoabdomen or haemothorax (n = 4/8, 50%) and trauma (n = 3/8, 38%) and in 36 dogs with angiostrongylosis (n = 12, 33%), neoplasia (n = 7, 19%), liver disease (n = 4, 11%) and others including apparently healthy dogs (n = 3, 8%). Hyperfibrinolysis was associated with prolonged EXTEM and APTEM (EXTEM with added apoprotein for inhibition of HFL) clotting time and decreased FIBTEM (EXTEM with added cytochalasin D for inhibition of thrombocytes) maximum clot firmness (MCF) in dogs and cats and with decreased EXTEM MCF in dogs. Bleeding dogs had significantly hypocoagulable EXTEM tracings. Fulminant HFL was associated with severe hypofibrinogenaemia in dogs (P = 0.005) and was not associated with survival to hospital discharge. Evidence of HFL was demonstrated in dogs and cats with bleeding, trauma, parasitic and neoplastic disease. HFL is associated with late and weak clot formation.

Abstract

Hyperfibrinolysis (HFL) is a pathophysiological mechanism that has not been described in dogs or cats extensively. The aim of this study was to describe rotational thromboelastometry (ROTEM) parameters and underlying diagnosis in dogs and cats with HFL and evaluate association with bleeding diathesis. The ROTEM database was retrospectively searched for EXTEM (ROTEM activated with proprietary tissue factor) tracings with maximum lysis at 60 min ≥15%. Concurrent ROTEM and plasma coagulation tests, thrombocyte number, diagnosis and survival to hospital discharge were extracted from medical records. Analysis of differences between dogs and cats and of factors associated with bleeding, fulminant HFL (clot breakdown within 30 min) and survival to hospital discharge were performed.

Hyperfibrinolysis was detected in eight cats presenting with haemoabdomen or haemothorax (n = 4/8, 50%) and trauma (n = 3/8, 38%) and in 36 dogs with angiostrongylosis (n = 12, 33%), neoplasia (n = 7, 19%), liver disease (n = 4, 11%) and others including apparently healthy dogs (n = 3, 8%). Hyperfibrinolysis was associated with prolonged EXTEM and APTEM (EXTEM with added apoprotein for inhibition of HFL) clotting time and decreased FIBTEM (EXTEM with added cytochalasin D for inhibition of thrombocytes) maximum clot firmness (MCF) in dogs and cats and with decreased EXTEM MCF in dogs. Bleeding dogs had significantly hypocoagulable EXTEM tracings. Fulminant HFL was associated with severe hypofibrinogenaemia in dogs (P = 0.005) and was not associated with survival to hospital discharge. Evidence of HFL was demonstrated in dogs and cats with bleeding, trauma, parasitic and neoplastic disease. HFL is associated with late and weak clot formation.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:05 Vetsuisse Faculty > Veterinary Clinic > Department of Small Animals
05 Vetsuisse Faculty > Veterinary Clinic > Department of Clinical Diagnostics and Services
Dewey Decimal Classification:570 Life sciences; biology
630 Agriculture
Uncontrolled Keywords:Animal Science and Zoology, General Veterinary, Acute traumatic coagulopathy, Angiostrongylus vasorum infection, Haemoabdomen, Haemoperitoneum
Language:English
Date:1 December 2018
Deposited On:22 Nov 2018 09:09
Last Modified:17 Sep 2019 19:44
Publisher:Elsevier
ISSN:1090-0233
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.tvjl.2018.11.002

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